1. Field of the Invention
The invention is directed to organ protectant solutions, and more particularly, to a solution which prevents or reduces in vivo lethal swelling of tissues and organs during periods of warm ischemia due to lack of oxygen delivery and oxygenation.
2. Prior Art
Initial therapy of trauma and hemorrhage shock centers on effective cessation of bleeding and on the infusion of large volumes (2 to 8 liters) to replace lost blood volume. This is considered necessary to restore normal circulatory functions such as arterial blood pressure, cardiac output, oxygen consumption and renal function. Conventionally isotonic fluids are used for high volume resuscitation. Many cellular complications and practical limitations have been cited while using high volume fluids for resuscitation.
Recently, successful resuscitation of hemorrhaged animals and injured patients has been accomplished with low volume hyperosmotic saline solutions. Glucose or mannitol has been tested with less successful results. Small volume resuscitation has been successfully used in some cases using hyperoncotic albumins or high molecular weight tense state polymerized hemoglobin's. The use of hypertonic saline solutions (HS) or colloid solutions (albumin, HES, Hetastarch, Hextend) have had very limited success in clinical trauma and resuscitation, and, due to their mechanism of action, they do not prevent cell swelling.
In the case of uncontrolled donation after cardiac death (DCD) organ donation, controlled DCD organ donation and brain death organ donation, the vital organs are removed from the body as quickly as possible and subsequently the vital organs are preserved in appropriate media to maintain the organ functions. Low volume resuscitation in recently expired patients prior to removal of vital organs to maintain the vitality of the organs and to prevent lethal organ swelling is not usually practiced.
None of these procedures is known to be effective in preventing lethal cell swelling in vivo. In recently expired patients and hemorrhagic shock and trauma patients there is substantial intracellular oxygen deprivation which in turn drops ATP concentration. Due to lack of ATP sodium pump fails, free sodium enters the cell followed by osmotic water movement causing cell swelling. There is no present day technology to deal with cell swelling of organs from DCD donors before harvest or cell swelling in organs in patients with severe shock.